Update, post-grad life: moving to NYC and starting a new full-time job has left me feeling a bit exhausted and mechanical these days, leaving little energy for creative or intellectual endeavors. I intend to make time to write soon.
Bad Vibes
My essay for The New Inquiry. Vibes vs. rationality, y’all
“The cultural dichotomy of ‘men’s rationality’ versus ‘women’s intuition’ was given medical legitimacy when hysteria became a psychiatric label in fin-de-siècle patriarchal Vienna, deployed as diagnosis against bourgeois women. Medical authorities at the time believed women to be innately governed by their unbridled emotions and sexual urges, and this disorder manifested in its subject when she repressed these “natural” tendencies.With the invention of this disorder, women were pathologized as tending toward the emotive, the sensate, and the visceral, while simultaneously being barred from “rational” speech in any other register. Though hysteria is no longer recognized by the medical establishment which created it, the cultural impact of the hysterical woman’ lingers and informs responses to allegations of stalking and sexual violence. And it becomes particularly difficult when this issue of gender intersects with that of race or class (the police officer sent over to write my report within the first few minutes inquired about my immigration status). Female victims too must fight against suspicion and produce material evidence in excess of their word for their cases, the most conclusive of which finds its expression on the body as injury, the result of attack or assault.
Against Rationality
As a graduate student this past year, I have spent an inordinate amount of time directly in front of a computer screen. As such, I have spent an inordinate amount of time logged onto Facebook and am kept abreast of what’s “trending” among my 300+ friends. Some time ago, I noticed this meme circulating on my wall, usually shared from a page called “I fucking love science”:
I’m studying for the GRE right now, in preparation for taking the exam in mid-November. This unfortunately coincides with a stage in my life in which I’ve grown increasingly anti-rationality, that is to say, I am very much against the creeping rationalization of everyday life. I spend hours a day reviewing for the quantitative reasoning portion of the exam, and I seem to make very little progress, not only because I haven’t seen most of these concepts since high school, but also because deep down, my body vehemently rejects it, rejects the idea that something as broad, variant, and nebulous as intelligence can be reduced to a numerical score. I refuse to be translated into a number, emplotted onto a linear graph.
As evidenced by the above meme, these days people tend to put a lot of weight in “science” – and by extension, rationality — in its primacy of tangible, observable evidence and causal relations, which is then translated into the reductionistic language of numbers, then data, then bar graphs and pie charts. But science is not infallible and its epistemology not impervious to critique; it expresses certain social and political imaginaries and determines, delineates, constrains our conditions of existence. The framework of rationality and science is so pervasive that we never think to question it, we just assume that it is. This framework: we are simultaneously interpolated through it and constrained by it.
Another example of the increasing rationalization of everyday life: our dynamic, lived bodies are now reduced to biomedical objects. In the post-Enlightenment taxonomic tradition, any physical disorder experienced by the self is causally attributed to a physiological dysfunction within, and that illness is localized on the body, legitimized through the assignment of a disease label, and made the object of medical intervention. Even psychological disorders now are increasingly being pinpointed to neurological causes, and a broad range of overlapping, “abnormal” behaviors are assigned distinct, immutable categories and given medical legitimacy through the Diagnostic and Statistical Manual of Mental Disorders (DSM). Even attributes which are socially conditioned are now given a basis in biology. A few weeks ago, I came across an academic journal article in which scientists now claim that an individual’s political leanings can be traced to physiological or genetic differences (Hibbing, Smith, and Alford 2014), as if liberalism or conservatism are pathologies. The biomedical body is one that is biologically or genetically deterministic. Anthropologist Michael Taussig once argued that our tendency as a society is to affix culture onto nature, thereby giving the former the appearance of that which is innate, fixed, and “natural.”
Conservative Christians commonly argue against gay rights by invoking that such a lifestyle is not “natural,” that the purpose of sex is biological reproduction, which can only occur between a man and a woman. Conversely, gay rights activists claim that homosexuality is not a choice, but rather rooted in a “gay gene,” or they point to the existence of same-sex relationships within other realms of the animal kingdom. We see here competing claims to biolegitimacy. I give no credence to either side of the debate or sexual categories for that matter. Sexuality is fluid – to identify as “gay” or “straight” constrains you, constrains your sexuality to an immutable political identity: straight people are straight, gay people are gay, and there is no moving in-between.
This fascination with sexual identities and labelling others as L, B, G, T, Q, or whatever lends support to the politics of visibility in which we are so enmeshed, all part of modernity’s obsession to “see” and to “know” Others in order situate them within (and dominate them through) a matrix of surveillance. These fixed sexual (and ethnic, racial, gender, etc.) categories imposed by sovereign power are the very essence of its biopolitics.
This post began with my frustration with the GRE and somehow progressed into discussions of the biopolitical. The common thread here is that that science and epistemology should be subject to critique and that there are other frameworks by which to understand the world: ones informed by intuition, lived experience, subjectivity, phenomenology. When we are placed into taxonomic categories, we lose something of ourselves. Resist rationality and its encroachment into everyday life.
Citation:
Hibbing, John R., Kevin B. Smith, and John R. Alford.
2014 Differences in Negativity Bias Underlie Variations in Political Ideology. Behavioral and Brain Sciences 37 (3): 297-307.
“The invention of madness as a disease is in fact nothing less than a peculiar disease of our civilization”
Often presented as a neutral, scientific body of knowledge, the realm of health and medicine has always surreptitiously been deployed by those in power as a form of social control. Within the past two centuries alone, the discourse of Western medicine has been utilized as a justification for colonialism (Vaughn 1991), a transmitter of patriarchal authority over women’s bodies during the Victorian era (Bernheimer and Kahane 1990, Gilman 1985, Turner 1987), and a means of regulating sexuality (Gilman 1988 and 1995, Horton and Aggleton 1989, Triechler 1987). Not only are illnesses of the body targeted by this medico-cultural apparatus, but since the “invention” of madness as a disease and subsequently psychoanalysis as the means of treating it, various mental illnesses have also increasingly been discursively constituted and subsumed within this network. As such, psychoanalysis and psychiatry have functioned as a way of turning individuals into what Foucault refers to as “docile bodies,” or “one[s] that may be subjected, used, transformed, and improved…through [the] strict regiment of disciplinary acts” (1991[1977]: 136). This essay will explore how bodies are rendered docile through the discursive construction of madness and mental illness, with a particular emphasis on the prison setting. I focus on this particular institution, because within this social milieu, inmates are situated at the convergence of two disciplinary regimes – not only are they subject to the medical authority of the prison clinicians itself but also to the surveillance and security apparatus of the prison setting. This essay will examine how this intersection of power and the ideology of rationalization interpellates the mentally ill inmate as a subject, with the underlying assertion that medical and psychiatric disorders are far from objective fact; rather, they are embedded within the localized, moral worlds from which they emerged and are thus culturally informed as such.
In his text Medical Power and Social Knowledge, sociologist Bryan Turner examines the manner in which social policy has evolved to manage its “mad” Others. Turner draws a link between those ostracized as “mad” and subsequently flogged during the Middle Ages and those categorized as mentally ill today, claiming, “The notion of ‘demonic possession’ by evil spirits and the term ‘madness’ have as a result been gradually replaced by descriptively neutral terms and scientific theories expressed in the notion of mental illness, which it is argued by psychology, do not carry or imply any moral judgement on the behaviour of those labelled as mentally ill” (1987: 60). Drawing on Foucault, he posits that “it is the discourse of insanity within the medical profession itself which creates and constitutes a unity which we then call sane and insane behaviour” (1987: 61). Those labelled “insane” then, are simply those who did not conform to the set social norms of behaviour; as individuals are categorized as such by the medical authorities, the diagnostic category and the individual it describes mutually constitute each other in a flowing back-and-forth “looping effect of human kind” that both reifies the former and gives subjective reality to the latter (Hacking 1986).
The boundary between reasonable and unreasonable behaviour, as well as the institutional settings and disciplinary regiments to correct the latter, have always been imbued by local cultural understandings. For instance, when leprosy came to be eradicated in the fifteenth and sixteenth centuries, criminals and vagabonds soon replaced the leper as the objects of public moralizing in the Euro-Christian imagination. Just as the leper was subject to social marginalization through confinement in separate colonies and forced to wear special clothing which indicated to the public his condition, authorities rounded up this new group of stigmatized individuals onto what was known as the Ship of Fools, forcing them to embark on an indefinite journey up and down the rivers and canals of Europe. Categorized as “mad,” medical authorities pronounced that the rocking of the ship to be proper therapeutic treatment for their condition. Likewise, the General Hospital in Paris was established in 1656, ushering in an era of what Foucault describes as “the great age of confinement” (2003[1977]). Reasons for incarceration within the hospital ranged from “derangement of morals,” to suicide attempts, spousal abuse, and criminal activities (Foucault 2003[1961]: 61). Ostensibly set up as a response to the growing number of those deemed insane, the General Hospital was, in fact, largely unconcerned with their medical treatment. It was “instead a system of order based upon monarchical and bourgeois power…concerned with correction, punishment and management not with therapy or moral cure…[and was] a response to the economic crisis of the seventeenth and eighteenth centuries functioning as a form of discipline over the unemployed and the unemployable” (Turner 1987: 64).
The “madman” was conceptualized as an individual in human form, but harbouring an animality within that necessitated physical restraint and discipline. In his paper, “The Domestication of Madness,” sociologist Andrew Scull explores some of these disciplinary procedures exercised over those labelled mad in order to “domesticate” or “tame the wildly asocial…to transform [them] into at least a facsimile of bourgeois family life” (1983: 233). These efforts ranged from simply chaining and whipping the madman, to elaborate contraptions built specifically to drive the animality out of him, including one which restrained the individual so that cold water was poured over his head to simulate drowning; coffins with holes drilled into them, in which the victim would be placed before being submerged into a large bath of water; and Joseph Mason Cox’s “swinging chair,” on which the individual was seated and then swung around continuously, designed to produce extreme nausea and vertigo (1983: 243-244).
Beginning in the eighteenth century, however, disciplinary control over the insane came to take a more humanitarian turn. In 1729, William Tuke established the Retreat in York; in lieu of the cruel corporal punishment described above, the treatment administered was guided by “family norms” and a sense of morality informed by Tuke’s Quaker beliefs. According to Turner, “Punishment and incarceration were in this [disciplinary] regime to be replaced by education, gentle but firm control, encouragement and instruction…classification, watchfulness, vigilance, kindness, and cleanliness” (1987: 65). This new treatment was embedded within the understanding that the mad could be cured, not through the domestication of their animal instincts, but through moral reformation. Similarly, Pinel, considered the architect of the modern asylum movement, proposed in his Treatise on Insanity (1801) that rather than using whips and chains to “tame” the mad, employment opportunities should be made available, so that discipline could be exerted in the form “regularity and method” (Turner 1987: 66). This logic, of course, coincided with the Industrial Revolution, which reformed understandings of bodies in the Euro-American consciousness as ones that should be productive of capitalist labour. And with the Industrial Revolution came the decline of the family as a unit of protection and support, and – at least in the US – a hyper-individualistic ideology which impeded social protection of those labelled as insane (Turner 1987: 69). As such, the number of asylums exponentially increased in the US and Europe, as they became the default “dumping grounds” for those who were left behind by industrialization, who could not make their bodies perform that kind of labour demanded. The regiments for the insane proposed by Tuke and Pinel, then, were not so much as a more humane form of medical treatment, but a reformed disciplinary apparatus that coalesced around a new religio-moral understanding of the productive, capitalist body. Rather than employing the threat of corporal punishment and physical violence, the new regiments exercised social control through the “anxiety of individualized responsibility” (Turner 1987: 66) and guilt around the idle body. In this way, these institutions deployed a “mechanics of power” that “defined how one may have a hold over others’ bodies, not only so that they may do what one wishes, but so that they may operate as one wishes, with the techniques, the speed and efficiency that one determines” (Foucault 1991[1977]: 138).
The remnants of this religio-moral logic continues to imbue the perceptions and treatment of the mentally ill today. Just as treatment of the mad individual involved the submission of his body to the disciplinary apparatus of Tuke’s Retreat or Pinel’s asylum which would, in turn, precipitate a kind of redemption in which he would be restored to normalcy, contemporary psychiatry brands itself as a kind of “technology of hope” that requires a similar acquiescence to its medical authority (Blackman 2007). The individual’s disorder is conceptualized much like original sin, and only through the submission of his body to the medical and psychiatric apparatus can he ever be fully redeemed. In the contemporary secular scientific landscape, the religious undertones of this discourse is further complemented by the post-Enlightenment rationalistic, taxonomic impulse to classify abnormal behaviours into distinct, immutable categories, as embodied by the Diagnostic and Statistical Manual of Mental Disorders (DSM). This authoritative guide for diagnosing psychiatric disorders dissociates all mental illnesses of their socio-cultural contexts, adhering strictly to a biomedical model of behavioural abnormality. The DSM exists as a self-referential producer of medical knowledge; most psychiatric academic journals demand that research papers discussing a mental disorder qualify it in terms of the manual (Hacking 2013: para. 6). With each edition, more and more behavioural abnormalities – which would have in the past been merely defined as “insanity” — are subsumed under its diagnostic classifications; schizophrenia boasts several subtypes, and bipolar disorder is split into bipolar I (described as “bipolar lite”) and bipolar II (Hacking 2013: para. 10). The increasing expansion of the DSM corresponds accordingly to the pharmaceutical corporations’ continual quest to discover new markets for new drugs. The current edition, the DSM-5, was released in May of 2013 and consists of 947 pages.
This biomedical understanding of psychiatric disorders absolves individuals of responsibility for their illnesses, displacing blame instead onto causal factors such as genetic or neurological abnormalities. However, this hegemonic model – like Tuke’s Retreat and Pinel’s asylum — also gestures towards an underlying form of social control. By attributing behavioural disorders to a purely biological cause and ignoring social factors, the psychiatric industry promotes pharmaceutical drugs as the only sanctioned form of medical intervention, in effect alienating those who do not wish to rely on psychopharmaceuticals or those for whom these drugs may not be effective. As Lisa Blackman (2007) asserts, psychiatry bifurcates its subjects into the distinctions of “non-compliant” and “compliant,” based on individuals’ degree of willingness to concede to this disciplinary regiment. Whereas the non-compliant subject refuses to acknowledge his condition or objects to taking his medication, the compliant subject “is one who is able to declare themselves [sic] as suffering from a mental disorder. They are willing and able to position themselves as able to triumph over their affliction through the administering of drugs as both restoration and as a prophylactic” (Blackman 2007: 8). Psychiatry and the medicalization it promotes, then, constructs itself as the only path toward the realization of a “normal” self, effectively coercing individuals to submit to its rehabilitative regiments. However, as Blackman states, the notion of adversity and eventual redemption is very much culturally informed by a Western conceptualization of life as a teleological progression from hardship to ultimate restoration, in which “[s]uffering is constituted as a temporary interruption, where a range of what might be felt as inchoate bodily and psychic sensations is made intelligible through a particular narrative coherence. This coherence is usually structured through a linear movement from crisis through to rescue and recovery” (2007: 9).
Within the prison setting, the religious discourse surrounding mentally ill inmates is even more acute, though their perceived odds of recovery are much bleaker than those outside. Additionally, it is within this institutional milieu that the full authoritative power of the DSM and psychiatric discourse is laid bare. Though the DSM no longer lists “psychopathy” as a diagnostic category, changing it (along with “sociopathy”) to the more neutral, less derogatory “antisocial personality disorder (ASPD),” the term continues to be regularly utilized within the prison system in describing inmates. This disorder is characterized by a “persistent regard for and violation of the rights of others…[as well as] superficiality, grandiosity, lack of remorse, lack of empathy, impulsiveness, and childhood and adult antisocial behaviour “ (Rhodes 2002: 447). The DSM and forensic psychologist Robert Hare’s book Without Conscience: The Disturbing World of Psychopaths Among Us construct the body of knowledge surrounding psychopathy to which prison authorities often refer. Both of these texts – as well as the majority of medical literature — maintain that psychopathy is an essential character trait of the individual; therefore, the condition defies any sort of treatment whatsoever – it can only at best be “managed.” It thus falls into the typology of Axis II disorders which refer to major character or personality conditions, in contradistinction to Axis I disorders, which comprise major mental illnesses such as bipolar disorder, schizophrenia, social anxiety, and chronic depression. In the latter classification, psychosis may be induced through stress factors, but it is understood to be a short-term, transient state, and the “authentic” self will once again re-emerge. Psychopathy, conversely, is a permanent condition which supposedly inheres in the personality of the individual. When Axis I sufferers undergo a psychotic state, their actions are perceived as uncontrollable and irrational, whereas the medical discourse constitute psychopathic individuals as hyper-rational, fully aware of their actions and their uncanny ability to manipulate people into giving them what they want.
As psychopathy is constructed as innate to the character of the prisoner, underlying religious understandings merge with psychiatric discourse when speaking of a particular individual. During her ethnographic fieldwork in a maximum control prison, anthropologist Lorna Rhodes stated that one mental health worker she interviewed claimed, “The really scary inmates are evil in the biblical sense of good and evil” (qtd. 2002: 452). Another stated that being near psychopathic inmates made her feel as if she was “sitting with evil…I had to have this fortress of goodness around me as I was talking to them” (qtd. 2002: 451). Many of these medical workers subscribe to the belief that psychopathy forms as a result of abuse during the formative years of childhood, thereby rupturing the “magic cycle” of parental bonding that “give[s] birth to the soul” (Rhodes 2002: 452). According to Rhodes, “From this perspective, early bonding is a kind of redemption and the unbonded child – almost as though carrying a kind of original sin – is damned” (2002: 452). In this way, the localized, moral world of the “outside” gives shape to how medical workers perceive psychopathic inmates inside the prison and in turn, forms the latter’s subjective realities.
Because psychopathic individuals are constructed as presenting themselves as charming, amicable, and alluring in order to manipulate others into doing what they wish of them, what they say or do is almost always disregarded a priori. In this way, the body of medical knowledge discursively constitutes the category, and any type of behaviour on the part of the individual only reifies the classification – his violent outbursts are perceived as typical of his psychopathic condition rather than as a reaction to spending twenty-hours a day in solitary confinement, yet any behaviour that may be interpreted as amiable is immediately regarded with suspicion. As such, the inmates are locked into these discursive constructions, as one mutually constitutes the other. When one inmate categorized as psychopathic asked for a polygraph test during Rhodes’s research believing it would prove that he no longer harboured violent intentions and would release him from his maximum security solitary confinement cell, his request was immediately refused on the grounds that his condition made him so adept at acquiring the appropriate disposition to getting what he wanted, that he would surely pass the polygraph. The medical workers who issued the refusal pointed to Hare’s text as support for their decision. This inmate later relayed to Rhodes that he eventually would like to move back into the general population of the prison, but the stigmatization that came with his diagnosis occluded any such possibility. He lamented to her, “How am I supposed to be as a human being?” (qtd. 2002: 449).
The study of mental illness within the prison setting thus offers the study of the convergence of two disciplinary regimes that find their nexus upon the body of the inmate. According to Foucault, penal imprisonment serves the double function of punishment through the “deprivation of liberty” and as a site of transformation in which docile bodies are reformed to better fit the social body (1991[1977]: 233). Ideally, through the implementation of regimented order and a tight surveillance apparatus, “[t]he prison would create a situation in which the prisoner’s outer circumstances were tightly managed so as to reproduce the presumed order and rationality of modern life. The prisoner would respond by forming a narrative that incorporated rational self-control and inner inspection, thus internalizing these impersonal disciplinary forces acting upon him from ‘nowhere’” (Rhodes 2000: 352). This surveillance system is administered by way of prison guards, security cameras, and an overall panoptican feel that makes one sense as if he is constantly being monitored, thereby inducing him to discipline himself. According to Rhodes, surveillance is also conveyed through the idea of transparency – that is, making each inmate and his intentions known or visible. In his ethnographic research in Pacific Northwest Penitentiary (PNP), Joseph Galanek recalls one medical worker stating, “We treat the biological symptoms through pharmacology to get those under control, get the brain repaired, and the person’s thinking is now more linear, clear, organized. The Axis I symptoms are being controlled, the symptoms are being treated…You have the illness clearing up and the criminality comes to the forefront” (2013: 211). In other words, psychopharmaceutical intervention is deployed in order for the “authentic” criminal self of the inmate to emerge, thus rendering him transparent to prison personnel. Only then through knowing his true intentions can clinicians use their medical knowledge to produce a docile body upon which a refashioning of the self can take place. Once the self is refashioned, the prisoner is held up by authorities as a “model inmate” – an example by which all other inmates should seek to emulate. Within this framework, Axis II personality disorders can be seen as obstructions to such a transparency; psychopathy frustrates any attempts on the part of medical personnel to reveal an “authentic” self, because such a self always supposedly remains hidden beneath the duplicitous, impenetrable exterior of the psychopathic individual; his true intentions remain unknown perhaps even to himself. Thus, medical authorities assume these inmates to be opaque and unreadable, resistant to psychopharmaceutical treatment, and then relegate them to confinement cells where they are to be “managed” or “contained.” Consequently, Axis I and Axis II disorders form a dichotomous division of labour among prison personnel, between those attending to individuals who are to be treated (the former) and those who can only be held in custody (the latter). From a management point of view, the containment of prisoners suffering from Axis II disorders frees up scarce resources, permitting clinicians to focus on those suffering from disorders that they can successfully treat.
Though medical authorities see psychopathic inmates as resistant to treatment and thus cannot produce them as docile bodies, the confinement that they impose upon them is nevertheless a disciplinary measure in and of itself. Prison workers justify the solitary confinement of psychopathic inmates on the grounds that their less than human condition makes them suited for isolation. When speaking to Rhodes about the psychopathic inmates, they usually described them as predatory or animalistic in nature, lacking humanity or the capacity to feel sympathy. As one worker bluntly asserted, “Some people really are not human” (qtd. 2002: 451). Foucault argues, “In the reduction to animality, madness finds both its truth and its cure; when the madman has become a beast, this presence of the animal in man, a presence which constituted the scandal of madness, is eliminated: not that the animal is silenced, but man himself is abolished” (2003[1967]: 71). According to this logic, through solitary confinement, the psychopathic inmate’s true nature is made transparent; the human exterior is peeled back to reveal the predatory, animalistic self – the authentic self — beneath. Yet, most prisoners who had experienced any degree of solitary confinement had agreed on its capacity to produce violent behaviour (Rhodes 2002: 445). These violent outbursts are then attributed to the inmate’s psychopathic condition, further justifying his segregation. Hence, the discursive construct not only classifies the individual based on his condition but also in turn produces and reproduces that abnormal behaviour.
Likewise, according to Galanek, in 2009, 457 of the inmates at PNP – or roughly twenty percent of the total prison population – was receiving treatment for some form of mental illness. 214 of those 457 inmates qualified for the highest level of mental health care based on DSM guidelines (2013: 202). This illustrates how inmates, once situated within the disciplinary apparatus of the prison system, are produced as subjects by its mechanics of power. Through observations of the inmate and the studying of his medical and criminal records, prison clinicians weave together disparate pieces of evidence regarding abnormal behaviour over the course of a lifetime and ascribe to it a neat, typological classification as dictated by the DSM. By way of this process, “a chaotic life undergoes a transformation to a ‘mentally ill inmate’…or a case” (Galanek 2013: 208). Foucault however, contends that the prison not only attempts to reform delinquents but paradoxically produces them as well through the abuse of regulatory power (1991[1977]: 266). The setting therefore, encourages an adaptation to an “anti-social lifestyle,” demonstrating “that the prison itself is an etiological agent for personality disordered behaviors” (Galanek 2013: 213). In the cases of psychopathic and mentally ill prisoners, the penal institution and the authoritative body of medical knowledge put forth by the DSM work in tandem to realize the discursive subject and eventually bring him into being.
The act of diagnosing an individual as mentally ill thus remains an act of exclusion in an increasingly rationalistic world. The ever-increasing medical classifications in the DSM attempt to categorize abnormal behaviour (that is, abnormal from the standpoint of reason and rationality) into numerous types and subtypes, divorcing them from their socio-cultural contexts and basing them purely in biology. For most individuals diagnosed with a mental disorder, the displacement of blame onto biological causes may bring relief by absolving them of guilt and responsibility for their illnesses; however, within the bureaucratic institution of the prison, this logic undergirds a biologically deterministic understanding of inmates diagnosed as psychopathic. These inmates then become locked into that diagnostic classification; their actions, whether violent, acquiescent, or cooperative, are always perceived to typify what is understood as psychopathic behaviour, thereby reifying the discursive category ascribed to him. Within the penal institution, therefore, we can observe how the relationships of medical and institutional power interact to produce inmates as docile bodies and subsequently produce them as subjects. The interpellation of psychopathic and mentally ill inmates in the prison setting thus exposes both the mutually constitutive relationship between the signifier and the signified and how the impersonal ideology of hyper-rationality and increasingly specialized bureaucratization produces an iron cage into which individuals then become locked.
Works Cited
Bernheimer, Charles and Claire Kahane, eds.
1990 In Dora’s Case: Freud – Hysteria – Feminism. New York: Columbia University Press.
Blackman, Lisa
2007 Psychiatric Culture and Bodies of Resistance. Body & Society 13 (2): 1-23.
Foucault, Michel
1991[1977] Discipline and Punish: The Birth of the Prison. Alan Sheridan, trans. New York: Random House.
Foucault, Michel
2003[1961] Madness and Civilization: A History of Insanity in the Age of Reason. Richard Howard, trans. New York: Routledge.
Galanek, Joseph D.
2013 The Cultural Construction of Mental Illness in Prison: A Perfect Storm of Pathology. Culture, Medicine, and Psychiatry 37: 195-225.
Gilman, Sander L.
1988 Disease and Representation: Images of Illness from Madness to AIDS. Ithaca and London: Cornell University Press.
Gilman, Sander L.
1995 Health and Illness: Images of Difference. London: Reaktion Books.
Hacking, Ian
2013 Lost in the Forest. August 8: http://www.lrb.co.uk/v35/n15/ian-hacking/lost-in-forest
Hacking, Ian
1986 Making Up People. In Reconstructing Individualism: Autonomy, Individuality, and the Self in Western Thought. Thomas C. Heller, Morton Sosna, and David E. Wellbery, eds. Pp. 222-236. Stanford: Stanford University Press
Horton, Meyrick with Peter Aggleton.
1989 Perverts, Inverts and Experts: The Cultural Production of an AIDS Research Paradigm. In AIDS: Social Representations, Social Practices. Peter Aggleton, Graham Hart, and Peter Davies, eds. Pp. 74-100. Philadelphia: The Falmer Press.
Rhodes, Lorna A.
2002 Psychopathy and the Face of Control in Supermax. Ethnography 3 (4): 442-466.
Rhodes, Lorna A.
2000 Taxonomic Anxieties: Axis I and Axis II in Prison. Medical Anthropology Quarterly 14 (3): 346-373.
Scull, Andrew
1983 The Domestication of Madness. Medical History 27: 233-248.
Treichler, Paula A.
1987 AIDS, Homophobia, and Biomedical Discourse: An Epidemic of Signification. AIDS: Cultural Analysis/Cultural Activism. 43:31-70.
Turner, Bryan S.
1987 Medical Power and Social Knowledge. London: Sage Publications.
Vaughn, Megan
1991 Curing Their Ills: Colonial Power and Africa Illness. Cambridge: Polity Press.
Humanitarianism and Bare Life
The problematic of universal human rights poses an interesting question for humanitarian organizations operating in the modern global geopolitical order wherein citizenship rights are conferred through claiming belonging to a nation-state. The language of human rights emerged out of the atrocities of World War II and takes as its object the “presocial body” (Allen 2009: 172), the absolute zero degree of which we all share in common as human beings – that is, the biological body which exists anterior to social and political discursive constructions. This biological body of which we all possess also binds us together in the sense that we share a common capacity to suffer because of it, and in the face of that suffering, it is our moral imperative to eliminate it at all costs. The sheer force of human rights law lies in its declared universality — that these rights are endowed upon an individual by sheer virtue of his humanity. “In both human rights documents and discourses about them,” according to anthropologist Lori Allen, “these humanist tendencies and emotions are presented as being unmediated by cultural and semantic systems” (2009: 164).
However, a paradox emerges in the institutionalization of human rights discourses. Deterritorializing themselves as apolitical spaces for the pragmatic purposes of ensuring public support and funding and the ability to operate within the framework of the nation-state, humanitarian organizations can only attend to what philosopher Giorgio Agamben refers to as the “bare life” of those they purportedly seek to help. And it is through the various technologies that allow the organization’s mission to sustain itself – representational images of suffering bodies, third-person testimonies – that bare life is reified and reproduced. This essay aims to explore how the apparatus of the humanitarian organization and its attendant technologies create further divisions between First and Third Worlds, between those who can attach a transcendent political meaning to their work and those who can only exist as mere repositories of bare life. Furthermore, it seeks to address a broader question of how these organizations, rather than challenging state power, actually become extensions of sovereign control within the global geopolitical order. Unpacking these issues using Agamben’s notion of bare life as a theoretical framework, I wish to investigate how the paradox of humanitarianism is the foundational inequality of its mission behind its universalist claim.
Drawing on Aristotle, Agamben distinguished between two forms of life. The zoë represented “the simple act of living common to all living beings,” that is, biological life, and the bios, “which indicated the form or way of living proper to an individual or group,” which for humans was expressed through social and political existence (1998: 1). In contrast to Foucault, who asserted in the first volume of The History of Sexuality that sovereign power took its modern turn when it began to govern by way of biopolitical mechanisms – that is, the management of populations through clinical records, health statistics, and public health campaigns, in effect deciding who to make live and who to passively let die – Agamben adds as a corrective that biological life has always been at the center of state calculations. Illustrating his argument with that of the homo sacer, Agamben draws on the obscure Roman figure who was cast outside of the juridico-political order by the state, stripped of his political being (the bios) and reduced to what he refers to as “bare life.” Bare life differs from the natural life of zoë in that it is the life that emerges once the protection of the state is withdrawn; it is a life exposed to the violence of sovereign power, an aftereffect which entails “a zone of indistinction and continuous transition between man and beast, nature and culture” (Agamben 1998: 109). It is a life deliberately produced by the state through its abandonment. The homo sacer thus also became “sacred life,” that is, a life outside the protection of the state that may be killed with impunity but not “sacrificed” (his death taking on a transcendent meaning). Just as the state operates on the foundational basis of the “sovereign exception,” in which it positions itself both inside and outside the juridical order by creating and upholding the law but simultaneously holding the right to suspend the law whenever it deems fit, the homo sacer is similarly relegated to a state of “inclusive exclusion,” in which he is included in the political order (the polis) only to be excluded from it. Agamben argues that all forms of sovereign power have placed bare life at the heart of its calculations; because of this, rather than existing on opposite ends of the political spectrum, democracy and totalitarianism are actually two sides of the same coin. By sharing the same foundational basis of absolute control over an individual’s bare life, the seemingly innocuous population management techniques of the former can easily explode into the concentration camps of the latter.
Thus, to be born into the nation-state today is still to subject one’s biological body to the ultimate disciplinary power of sovereignty; by way of birth in a nation-state, the individual enters a social contract with that sovereign power in which he is endowed with political rights with the understanding that he may be “banned” from the polis at any given moment, reducing him to his bare life – that is, one stripped of civil rights and political agency and can only exist as a biological body; he then becomes homo sacer. Sovereign power constructs itself such that the individual can only realize his full humanity (the bios) through it, by way of subjecting his biological life (the zoë) to its ultimate authority, conditional upon the fact that its abandonment will produce a bare life exposed to its utmost violence. Within this framework of power, all life teeters on the precipice of the bios and bare life; all individuals have the potential to be relegated as homines sacri. Refugees, asylum seekers, and prisoners all present contemporary examples of this figure.
Furthermore, according to Agamben, like sovereign power itself, humanitarian organizations place bare life at the center of its project and, as such, operate through the mechanism of biopolitics. The proclaimed apolitical nature of these organizations allow them to secure funding and public support, as well as operate within the framework of the nation-state. However, without a political agenda, these organizations can only treat those they purport to aid as bodies to be managed, providing service insofar as keeping those bodies alive through distribution of food, vaccinations, and medical treatment. They can only sustain a bare life at the mercy of the humanitarian organization and the nation-state. In this way, both the refugee camp and the concentration camp represent the modern “biopolitical paradigms” of sovereign power; they are microcosms in which “inhabitants [are] stripped of every political status…wholly reduced to bare life…..[where] power confronts nothing but pure life, without any mediation” (Agamben 1998: 171) and where the control over life and death through the technologies of population management are at their most acute and pronounced. Moreover, if “humanitarian organizations…can only grasp human life in the figure of bare or sacred life, and therefore, despite themselves, maintain a secret solidarity with the very powers they ought to fight” (Agamben 1998: 133), then these organizations become extensions of sovereign power itself. Without challenging the offending state to grant unconditional human, political, and economic rights to those it victimizes, these organizations uphold the very structures which place “life’s subjection to a power over death and life’s irreparable exposure in the relation of abandonment” (Agamben 1998:83) at the center of its sovereign logic. In the contemporary global geopolitical order, this translates into humanitarian organizations attending to the bare life of Third World victims (the homines sacri) under the moral imperative of a universal humanity while tacitly operating under the auspices of First World sovereign power. In the humanitarian encounter, then, pure power confronts bare life in the most unequal of exchanges, thereby ossifying the divide between Global North and South.
In theory, the integrity of the biological body – the presocial body — and our shared recognition of its capacity to suffer undergirds humanitarian logic. Paradoxically, however, the “imagined identification” which allows us to empathize with victims of human rights abuses seeking asylum also arouses our suspicions, as we admit that even our own motivations may sometimes be duplicitous themselves (Kelly 2012). Thus in practice, the body is also the objective site of evidence of human rights violation by way of physical or psychological trauma, and through the act of witnessing, victimhood is represented (or re-presented) and enacted. Didier Fassin refers to Emile Benveniste in explicating the two Latin words for “witness”:
Testis is the “third party” who observes an event that brings two parties into conflict and who can help to resolve the dispute because he saw what happened. Superstes is the person who “lives on beyond” what happened; he experienced the event and survived it. In the first case the witness was external to the scene, but observed it: to be more precise, he has no vested interest and it is this supposed neutrality that is the grounds for hearing and believing him, including in legal proceedings. In the second case, the witness lived through the ordeal, and suffered it: it is therefore because he was present, but as a victim of the event himself and hence a survivor, that his word is listened to. The truth of the testis, expressed in the third person, is deemed objective. The truth of the superstes, expressed in the first person, is deemed subjective (2008: 535).
In other words, the victim of human rights abuse (the superstes) can only offer a narrative, a subjective truth, so he must present his body to the team of aid workers and medical personnel (the testis) for objective analysis and a final conclusion. The two testimonies are not equal. According to Fassin, “The second age of humanitarianism thus corresponds to the advent of the witness – not the witness who has experienced the tragedy, but the one who assists the victims” (2008: 536-537). The expertise of the latter is privileged over the word of the former. In countries such as France, where the granting of legal refugee status declined to as low as 18 percent in the 1980’s and 1990’s (Fassin and D’Halluin 2005: 598), what is at stake in this transaction is a medical certificate conferred by organizations such as Comede (Comité Médical pour Les Exiles), the Center for Rights and Ethics in Health (Centre droit Ethique de la Santé), and the Primo Levi Center, which would increase the likelihood of asylum. Thus, the asylum seekers are politically desubjectified and can only represent their experiences not through language, but through their biological bodies, and only through the medical personnel acting as testis are their accounts verified and re-presented to Ofpra (Office Français pour la Protection des Réfugiés et Apatrides), who in turn decides whether or not to grant the individual refugee status. Likewise, during her fieldwork within the Mishamo Hutu refugee camp in Tanzania in the mid-1980’s, Liisa Malkki observed that the United Nations High Commissioner on Refugees (UNHCR) staff often complained of refugees telling “stories”; as such, their accounts were often disregarded a priori, and wounds became “more reliable sources of knowledge than the words of the people on whose bodies those wounds [were] found…Their bodies were made to speak to doctors and other professionals, for the bodies could give a more reliable and relevant accounting than the refugees’ ‘stories’” (1996: 384). In this way, bare life is reified and subjected to the ultimate authority of the Western NGO or international organization.
Additionally, the refugee is not a given category; he is a discursive construct shaped by the rhetoric of aid institutions, legal practices, and administrative procedures (Peteet 2005: 50). As such, he is continually imagined as an object of intervention (Peteet 2005: 51) and as a depoliticized, ahistorical subject (Johnson 2011, Malkki 1996) who can only passively await the violence done onto him. Thus, in visual representations, the refugee is often depicted as suffering from ill health and abject poverty and often within a large mass of human migration. As the refugee is denied of voice, identity, and political agency, the aid worker substitutes himself as witness to the event experienced. An integral part of Medicine Sans Frontières’s (MSF) charter, for instance, involves testifying on behalf of those to whom they provide aid. MSF personnel take disparate narratives of suffering and weave them into a composite whole to re-present to media authorities in order to will governmental authorities to act. Through this endeavor, the media-savvy MSF transforms a “localised event” into a “global accident…which can now produce desirable social, political, or economic results” (Debrix 1998: 841). According to Fassin, “In the contemporary world, the prolixity of humanitarianism increases in parallel to the silence of the survivor. The discourse of the former substitutes itself to the voice of the latter” (2008: 537). The discourse colonizes language, as victims of political violence often adopt the Western NGO rhetoric of human rights as the idiom through which they refract their own experiences (Allen 2009: 166).
However, doubts over authenticity may arise when a refugee’s self-representation conflicts with how aid workers imagine him to be. Through discussions with the UNHCR staff in the Mishamo refugee camp, for example, Malkki observed that many of the them had grown skeptical of whether or not the inhabitants should even claim refugee status any more on account of their relative prosperity since arriving in 1972. Comments ranged from “Nowhere else in Africa do these people…receive their own land to cultivate…They say that these people are refugees; they should not have all the same rights as citizens” to “These people don’t look like refugees anymore. If you go to Mishamo …as a visitor, you will think these are just ordinary villagers” (qtd. in Malkki 1996: 383-384). Thus, for the UNHCR workers, refugee status was not only a legal category but also entailed a performative aspect, an embodiment of bare life.
Miriam Ticktin similarly illustrates that those deprived of humanity and reduced to bare life are expected by authorities to exist as little more than an embodiment of such a life through her study of undocumented immigrants, or sans papiers, seeking medical asylum in France by way of what she terms the “illness clause.” The illness clause was a provision to the Conditions of Entry and Residence of Foreigners lobbied for by the NGO Medicine Sans Frontières (MSF) in 1998 which would grant sans papiers already in France a residency permit provided they had acquired a life-threatening illness which could not be treated in their home country. In order to be passed, the clause was lobbied for under humanitarian grounds, thereby eliding any discussions of problematic French immigration policy or demands of economic or political rights for the asylum seekers. Rather, the state justified the provision on the grounds that it simply could not deport an individual if it would directly result in his death. As a result, an individual granted legal residency through the illness clause is additionally granted the right to rent a house and the right to open a bank account though paradoxically, not necessarily the right to work.
In her observation of two separate interviews for medical asylum in a state medical office, Ticktin noticed the markedly dissimilar reactions to two sans papiers the nurses interviewed. The case of Fatima, an Algerian woman who had been raped and disfigured by her uncle in her home country and then sent to France for medical care and was now hoping to have her residency permit renewed, was met with sympathy from the medical staff. They decided to renew her papers for medical treatment for an indefinite period of time on the basis that sending her back to Algeria would result in her being deemed unmarriageable by her family and lead to a life of societal marginalization. Conversely, an Algerian man who came into the office claiming he had suffered a heart attack several days prior and demanding that his papers be renewed so that he would not be separated from his wife in France was met with suspicion and impatience. As Ticktin observes, these encounters are always negotiated through a French colonial legacy and its latent Orientalist stereotypes. These two interviews and the differing reactions from the medical staff that emerged from each indicate expected norms in the representation of suffering bodies. In order “for help to be extended, humanitarianism often requires the suffering person to be represented in the passivity of his or her suffering, not in the action he or she takes to confront and escape it” (Ticktin 2006: 44). Humanitarianism animates suffering as spectacle, in which sans papiers are expected to perform a victimization, an enactment of bare life, within a transactional exchange that can only, at most, sustain that bare life. Fatima’s case was convincing enough, as she personified an idea of suffering already present in the nurses’ minds. However, the Algerian man’s “performance was not convincing because it was too active, he demonstrated too much agency – he was perceived as strategic and not as a suffering, passive body. His personality took up too much room in the narrative” (Ticktin 2006: 44).
In lobbying for the illness clause provision on grounds of compassion rather than directly challenging the French state on its restrictive immigration policy then, MSF and other humanitarian organizations which attend to sans papiers concede to sovereign power its ultimate authority to endow the individual with a full humanity realized through political existence not on the basis of being human alone but through subjecting his body to it. In turn, they also legitimize the nation-state and its foundational imperative of the bare life caught within its inclusive exclusion. Just as “man is the living being who, in language, separates and opposes himself to his own bare life and, at the same time, maintains himself in relation to that bare life in an inclusive exclusion” (Agamben 1998:8), the sovereign state similarly conceives immigrants, refugees, and asylum seekers as the Other external to itself, when in reality, processes of exclusion undergird the notion of citizenship rights and the nation-state itself. According to Rajaram and Grundy-Warr, “[T]he refugee [and other migrants] is integrally tied into the practices of excluding and including that constitute and maintain the faceted system of the nation-state” (2004: 39). Just as there would be no political existence for man without his bare life — despite his setting himself apart from it — without the migrants that sovereign power excludes, the nation-state would collapse upon itself. There can be no one without the Other.
In conclusion, humanitarian initiatives such as these solidify the power relations between First World bureaucracy and Third World medical asylum seekers and refugees. The technologies of representation and witnessing privilege the authoritative voices of the Western aid worker, thereby silencing the victim and denying him as a political subject. Thus, in this sense, humanitarianism further reifies the division between First and Third Worlds: between those who can speak and those who must be spoken for; those with the power to represent and those who can only be represented; those whose deaths in the field warrant media attention and those whose deaths become a banality; and those who can imbue their lives with political meaning through their work and those who can only exist as mere repositories of bare life. They bifurcate a world into those who are perpetually regarded with suspicion and can only embody silent, passive suffering and those who can act as veritable witnesses on their behalf — who can, through a series of probing interviews and intrusive medical examinations, extract that objective truth unqualified by language alone. In these scenarios, refugees and sans papiers subject their bodies to the violence of the humanitarian encounter, and these organizations exercise the ultimate control over life and death.
Works Cited
Allen, Lori A.
2009 Martyr Bodies in the Media: Human Rights, Aesthetics, and the Politics of Immediation in the Palestinian Intifada. American Ethnologist 36 (1): 161-180.
Agamben, Giorgio
1998 [1995] Homo Sacer: Sovereign Power and Bare Life. Daniel Heller-Roazen, trans. Stanford: Stanford University Press.
Debrix, Francois
1998 Deterritorialised Territories, Borderless Borders: The New Geography of International Medical Assistance. Third World Quarterly 19 (5): 827-846.
Fassin, Didier
2008 The Humanitarian Politics of Testimony: Subjectification Through Trauma in the Israeli-Palestinian Conflict. Cultural Anthropology 23 (3): 531-558.
Fassin, Didier and Estelle D’Halluin
2005 The Truth From the Body: Medical Certificates as Ultimate Evidence for Asylum Seekers. American Anthropologist 107 (4): 597-608.
Johnson, Heather L.
2011 Click to Donate: Visual Images, Constructing Victims and Imagining the Female Refugee.
Third World Quarterly 32 (6): 1015-1037.
Kelly, Tobias
2012 Sympathy and Suspicion: Torture, Asylum, and Humanity. Journal of the Royal Anthropology Institute 18: 753-768.
Malkki, Lissa H.
1996 Speechless Emissaries: Refugees, Humanitarianism, and Dehistoricization. Cultural Anthropology 11 (3): 377-404.
Peteet, Julie
2005 Landscape of Hope and Despair. Philadelphia: University of Pennsylvania Press.
Rajaram, Prem Kumar and Carl Grundy-Warr
2004 The Irregular Migrant as Homo Sacer: Migration and Detention in Australia, Malaysia, and Thailand. International Migration 42 (1): 33-64.
Ticktin, Miriam
2006 Where Ethics and Politics Meet: The Violence of Humanitarianism in France. American Ethnologist 33 (1): 33-49.
Words As Intervention 